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Comments by Gandalf47

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Posted on June 6 at 2:13 p.m.

What is the name of the consultant who was hired? Though I understand that Cottage has a big financial stake in this matter, what is their angle in all of this for THEM to fund the study? Aside from the fact that Cottage can AFFORD to pay for the study (how much was it, BTW?), my experience with Cottage is that when they hire a consultant to do a "survey" there is an implicit "unspoken agreement" in advance as to what the outcome will be. Cottage always does what is best for Cottage, and if that also serves the community in a positive way, so much the better.

Who vetted this firm and when, how much were they paid, and what EXACTLY did the RFP and, ultimately, the contract agree to study and to what end? Were they hired by Cottage with the input of the SBNC Board?

From what I read and know personally about he SBNC, they have been having management issues for several years. I know why the American Indian Clinic gets $100 per visit more than SBNC, and merging with SBNC will not transfer that rate to all the new patients. The rate that the Indian Clinic is based upon the number of "Federally-Qualified" health care visits by the number of "documented" Native Americans that are treated annually by the clinic. Actually, the SBNC has a reimbursement rate 3-4 what a normal PCP gets from Medi-Cal, and they get reimbursed the same rate that all doctors get from Medicare.

I have been privy to the manner in which the FQHC rate (reimbursement for Medi-Cal patients) was calculated for both clinics, and it is a minor "miracle" that the SBNC has as good a rate as they do. I have also been privy to watching how the upper management of the SBNC operates, and this last minute, "the sky is falling, help us avoid disaster", is just the latest in a line of bad management decisions, some of which are mentioned in the article.

The public needs to keep an eye on how this "plays out". The good of the community should trump the good of Cottage Health System. The County of SB Public Health Dept. should weigh in on this issue, as they have as much or more at stake than Cottage. This is a big deal!

On SOS for Neighborhood Clinics

Posted on May 27 at 9:36 p.m.

Got your goat, did I, Kenny? It's all about ME, now?

On Neighborhood Clinics In Real Danger of Closing

Posted on May 27 at 8:13 p.m.

Ken_Volek - You are a negative blowhard, and what does your last post even mean? Of the first 22 comments, 15 of them were from you and others going off about City politics and your pet peeves about taxes, vagrants, "Eating the Rich", the Montecito Association", "Occupy bulbouts", Fiesta, Randy Rouse, etc.. "foofighter" was trying to make some valid counterpoints, which eventually led him/her off the subject, too, and LH Thom actually attempted to get on point, too. I DID read the entirety of ALL the comments (not just yours, though you probably would rather it be so), and a large percentage of the discussion up until my first post was NOT specifically about the issue discussed in the article, and, more importantly, what we, as a community can or should do about it. I was just trying to draw the discussion back to the severe crisis that this community may face in a couple of months and what could be done in the short term. What's wrong with that? (I'm sure I will regret THAT question).

WRT to the contrast between a bunch of rich insurance fat cats wasting tens or hundreds of thousands of dollars "rewarding" themselves for huge profits with a "down low" celebration at the Sunken Gardens and Bacara Resort - I don't get what your "ha!" means. Is it that you support their huge profits and tone deaf celebration while local public health clinics go bankrupt .... or what, were you agreeing with me? I can't tell.

I guess if the discussion isn't about the City Council or some other local issues that personally excite your "sensibilities", it doesn't matter, right? Just because you have nothing better to do than post comments to the Indie all the day, every day, that doesn't mean that there are not REAL issues and REAL discussions to be had by those of us who care more about the community as a whole than you do about your "pet" issues. Just because you have lived here a long time doesn't give you a monopoly on the truth - a lot of us have lived here a long time. I've read your comments on other issues before, and you tend to be long on snarky opinions and short on facts. You never even addressed the substance of my first comment - you just attacked me, in "typical Ken V" fashion.

What kind of health insurance do you have Ken? Is it threatened by the possible closure of the SBNC? Do you even care, or is that not even on your radar? I'm just asking, since your comments don't seem to reflect a point of view either way - just attacks on this or that - anything but the topic at hand. "foofighter" was bending over backwards to try to engage you in a substantive discussion, to no avail, except for you to label him/her a "partisan hack". Ken - it takes one to know one.

On Neighborhood Clinics In Real Danger of Closing

Posted on May 27 at 5:32 p.m.

One other comment - Read The Angry Poodle for a stark contrast to this story. Disgusting!

On Neighborhood Clinics In Real Danger of Closing

Posted on May 27 at 5:30 p.m.

What a non-productive conversation! If one started about three comments in, they would have no idea that the SBNC system is in danger of going out of business. This is NOT even a City Government issue, it is a County Public Health Issue. SBNC plays a critical role in SB County's public health safety net, along with American Indian Health & Sevices and the County of SB Health Care Services. If SBNC goes out of business, the 2 remaining entities will be left to absorb the 17,000 patients and 56,000 visits referred to in this article. This is not feasible, as they are already stretched to the max. Cottage Hospital is the single private entity that has the most to lose in this crisis, as they will be the ones "eating" the ER uncompensated care, but the community as a whole will suffer as well. This private-sector issue can turn into a County Public health emergency, and a behemoth like Cottage has the resources to help to mitigate this problem, until, like "foofighter" suggests, Obamacare kicks in, but that is not until January. Cottage's BOD might see fit to part with some tiny percentage of that gazillion-dollar endowment of theirs and help the community get through this. If they could raise enough money to build the state-of-the -art facility that they currently have, they can come up with the $1.5M from "petty cash". The bigger question going forward is, what then?

I have worked within the local public health system in the past. I have firsthand knowledge what they are up against. I also know that this did not happen "over night", and question why we are just hearing about this now, allegedly 2 months before "Armageddon", when there are systems in place that can and should be able to forecast more than two months at a time. Not time to point fingers, but in order to save a necessary local asset, there needs to be proactive management in place to do so. This is a combination of a "perfect storm" of unfortunate events - the increasing number of uninsured patients since the economy tanked in '08 and, while unemployment may be decreasing, employers who provide healthcare are not., often "gaming" the system to hire more part-time workers to avoid having to provide health benefits, which forces these folks into the "system" to get health care. There is no where to go except for these local clinics.

The other interested party which IS governmental is the County of SB, who has the unfunded legal responsibility to care for these folks as the "provider of last resort". What this means to everyone now getting care at the County Health Care System, you will get less care with longer waits, which always costs more in the long run.

This is a major public health issue that should be addressed immediately by the entities with the means to do so. If there are private donors with the means, they should step up as well for the good of the community.

Those of you debating "vagrants" and "tourists" are off the mark.

On Neighborhood Clinics In Real Danger of Closing

Posted on July 19 at 10:41 a.m.

SB County's manner of "finding a way off the streets" is the jail. Over and over again, the mentally ill keep finding themselves charged with "crimes" that end them up in the County Jail, usually without their meds, any treatment, and necessary personal belongings, such as reading glasses or other necessary personal care items.

Since the penal system is the County's default mental health system, most homeless mentally ill persons eventually find themselves in jail, with nobody to represent them, and usually without the meds they need to function. If they don't have an interested family member, they are at the mercy of the system, which shows very little mercy.

Then mentally ill are treated as "less than", which means that they are considered with less dignity than even violent criminals. I have witnessed it with my own eyes, and it is deplorable how they are treated - mostly ignored, not listened to, and mistreated when their mental health symptoms are misinterpreted as hostile acts of defiance, which, in jail are punished. Sometimes the punishment is physical, but mostly it's emotional. The jail system has sadism down to a "science". If non-violent drug offenders and the mentally ill were removed from this system, there would be enough money left over to adequately treat these populations, not to mention freeing up the judicial system to prosecute REAL criminals. Go figure!

On Doing Our Best

Posted on May 6 at 10:29 a.m.

patrick58 - "We trusted our children in their care, after all". "And what kid or parent involved with it didn't adore their time there?" My point exactly, since I know of at least one kid and two parents who DID NOT adore their time there. Again, can't ANYONE think of any reason that there was not one single mention of Camp Lorr in his memorial? Is there something that would tarnish the "fantasy" that most people remember as Camp Lorr, while others remember it as "Hell on Earth"?

On Rath Shelton: 1923-2012

Posted on April 20 at 11 a.m.

Really? "We all know..." Please cite documentation to support your claim, "ChasLBerg".

By any chance, do you know how many legal residents of the state benefit from this program? Do you know how many children have a place to live or other things that we all take for granted due to this program?

Just throwing out generalized comments disparaging the thousands of deserving and eligible recipients of this program is pretty mean-spirited.

Let them eat cake, right?

On What's Penny-wise, Pound-foolish, and Completely Heartless?

Posted on April 20 at 10:08 a.m.

I had the pleasure of working with Libby for many years at the Rehabilitation Institute prior it being acquired by Cottage Hospital. Libby was not only a highly competent therapist, she was compassionate and a pleasure with whom to work. She pursued her non-clinical credentials, which only enhanced her skills as a clinical manager in a non-profit hospital which survived only due to the support of the community. Insurance companies, including Medicare, cover little or none of the services that Libby and her well-chosen staff provided. Quality of life issues are generally not considered priorities in the insurance world. But in Libby's view, quality of life for people who suffered from life-altering events was the key to how they lived the rest of their lives. Many of her patients returned to work and resumed being productive members of society. Others simply were able to learn how to enjoy their lives and overcome obstacles to their disabilities.

I remember countless times that Libby, fully aware of the fiscal constraints, would come up with creative and productive plans to raise money for a single patient's needs, or sometimes, on a larger scale. She never asked for the hospital to come up with extra money without a well thought out proposal on how to raise that money, and, consequently, her patients benefitted from her creative and dedicated work. She frequently spent her own time on evenings and weekends to provide quality of life opportunities for her patients. She also spent her own money in these endeavors. Libby was a gem who made the most of her opportunity to help others. I will miss her very much, as will countless others who had the pleasure to meet her.

My condolences go out to her family and everyone who knew Libby.

On Obituary for Elizabeth "Libby" Brown Whaley

Posted on March 27 at 10:41 a.m.

Any particular reason that Camp Lorr was not mentioned in this obit? I'm just asking, since Camp Lorr was a big deal to a lot of kids in this town. I find it curious that there is not even a reference to it.

On Rath Shelton: 1923-2012

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